Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 4301406796 | MI |
NPI | 1043314164 |
---|---|
Provider Name | William Stuart Gonte |
First Address | Southfield, MI 48034-7659 |
Second Address | Southfield, MI 48034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 30/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E76672 | (02) |